For many people, eating is one of life’s pleasures. But for those living with avoidant/restrictive food intake disorder (ARFID), it can feel more like a chore or even a source of anxiety and disgust.
Unlike anorexia or bulimia, ARFID isn’t about weight loss or body image. It often stems from fear of choking or vomiting, a heightened sensitivity to smells and textures, or a simple lack of interest in food. But the health consequences can be just as serious, including malnutrition and related complications.
A new study from the University of Leipzig Medical Center, published in Psychotherapy and Psychosomatics, sheds light on a group that’s been largely overlooked: adults with ARFID who also have higher body weight.
“Our latest findings show that ARFID can also affect adults with higher body weight — although the symptoms may differ in some respects. These patients require specific diagnostic tools and tailored treatment strategies,” said Dr. Ricarda Schmidt, senior author of the study.
Researchers surveyed 369 adults, with a subset completing in-depth clinical interviews. They found that 34% of participants with ARFID had elevated body weight. This group tended to show more selective eating patterns, experienced greater daily impairment and faced a higher risk of metabolic disorders than their lower-weight counterparts. Every participant in the higher-weight group reported psychosocial impairments, compared with 65% of those with lower body weight.
Many also expressed concerns about body shape or weight, a finding that, according to Schmidt, often leads to misdiagnosis.
“ARFID frequently goes unrecognized in people with higher body weight, because their weight-related concerns are mistakenly viewed as signs of other eating disorders or simply attributed to dieting,” she said.
The authors call for updated screening tools, better clinician training and treatment approaches tailored to this population’s needs.
“With these findings, we are helping to close a significant research gap and broaden the understanding of this disorder to include a population that has largely been overlooked,” Schmidt said.
This work was supported by internal funds of the Behavioral Medicine Research Unit at the University of Leipzig Medical Center.